Escolar Documentos
Profissional Documentos
Cultura Documentos
Health History
Chapter 4
• Silence
– Necessary for clients to reflect/gather courage
(painful topic/issues)
– Feedback that client’s not ready to discuss
topic/evaluate approach
– Become comfortable with silence
• Displays of emotion
– Crying natural: should be permitted
• May indicate need for follow-up
• Compassionate response enhances relationship
– Anger: uncomfortable, identify source of anger
(you/another person)
• Discuss approaches/acknowledge feelings
• Determine if client able to continue interacting with
you
Copyright © 2005, Mosby, Inc. All rights reserved.
Challenges to the Interview
• Managing overly talkative clients
– Detail problems/get distracted
– Focus on past events not relative to present
– Discuss other issues
– Redirect conversation; closed-ended
questions may help
• Cultural differences
– Nurse accountable for cultural competence
• Demonstrate communication between/among
cultures; skill outside own culture
– Interact with individuals as unique with past
experiences, beliefs, values learned and/or
passed down
• Cultural differences
– Don’t stereotype: diversity within cultures
– Ask about experiences: what clients
value/characterize their culture
• Increases nurse’s knowledge
• Demonstrate interest in individual
• First visit
• Updated as changes happen
• Picture of client as unique individual
• Review of systems
– General health status: energy levels, growth
– Integumentary system: skin, hair, nails
– Head and neck: eyes, ears, nose, mouth, neck,
health promotion
– Breasts